What Is a Foley Bulb Induction?

A Foley bulb catheter, which is also called a Foley balloon catheter, is sometimes used for labor induction to promote contractions and dilation of the cervix. This induction method is generally an effective, safe option.

The Foley catheter is a device normally used to empty the bladder. But in this use, the balloon portion of it is inserted into the uterus and inflated, which puts pressure on the cervix to promote dilation and contractions.

How It Works

This induction method begins by your practitioner inserting the Foley balloon, sometimes using a speculum, into the uterus via your vagina. The balloon is placed between your amniotic sac and lower uterine segment (bottom of the uterus) on the other side of your cervix. The balloon is then inflated with saline solution and left in place. It's taped to your thigh to provide gentle traction. The catheter will typically fall out on its own once you're 3 centimeters dilated.

When This Induction Method Is Used

A Foley bulb catheter may be used for induction in a variety of situations, including when a provider deems it is necessary to induce labor as opposed to awaiting spontaneous onset of labor or when you're at or past full-term or your water breaks but you're not in labor. The procedure is used when your baby is in the head-down position and no placenta problems (such as placenta previa) are present. This induction method can be used either on its own or in conjunction with other induction techniques.

How It Feels

This induction procedure is performed while you are in a reclined position with your feet in stirrups. Your specific experience with this induction method will vary depending on the condition of your cervix at the time of insertion, the technique used, and if you've had a baby before (which may make your cervix more favorable to induction).

Many people say that insertion is the most uncomfortable part of the procedure. It may feel similar to having a pelvic exam, a feeling of pressure, and/or pain. Some describe having sharp pelvic pain during insertion, but the pain usually recedes after insertion. After the catheter has been placed, it just may feel a little strange, possibly like having a large tampon in. Contractions and dilation may begin soon after the balloon is inflated—or it may take 12 to 24 hours for labor to begin.

When the catheter is inserted you can go about most of your daily activities, such as showering, using the toilet, or walking around. The only thing you do need to avoid is sexual intercourse. Also, wash your hands before and after they might come into close contact with your vagina, such as when you use the toilet.

Pros and Cons of Foley Bulb Induction

The goal of this induction is to cause your cervix to mechanically open. Sometimes this will start labor spontaneously or it may simply make your cervix more favorable for a Pitocin or other drug induction or amniotomy (breaking the bag of waters).

Benefits

The use of the Foley balloon catheter has a very good track record of pregnant people giving birth within 24 hours of insertion. It also has similar or lower cesarean rates associated with its use than combinations of the other methods of induction.

There is also the benefit that it is less likely to cause changes in your baby's heart rate or fetal distress than other methods of induction. This may be why the cesarean rate is lower in some usage combinations. Still, you may have to have your baby's heart rate monitored before, during, and just after the procedure to see if the baby tolerated this process, but this method is less likely to cause fetal distress.

Potential Risks

The main drawbacks of this procedure are that it can be painful during insertion of the catheter and it might not induce labor, perhaps necessitating another method of induction. Uncommon complications of this procedure include the following:

• Baby moving from the head down to breech position (1.3%)
• Fever (3%)
• Non-reassuring fetal heart tones (2%)
• Pain requiring the removal of the catheter (1.7%)
• Vaginal bleeding (1.8%)

Vaginal Birth After Cesarean

The Foley catheter may be suggested if you had a previous cesarean section or if you have a scarred uterus. Use of this method of induction for birthing parents who are hoping for a vaginal birth after cesarean (VBAC) is limited but positive. A small study of 151 patients found the rate of vaginal birth was 54%. Complications were within the normal range.

Outpatient Use

Outpatient use of the Foley balloon for labor induction has been explored in a couple of small studies in Australia of women with low-risk full-term pregnancies. They found that the benefits of the Foley balloon were still present and there were no complications in the groups. The American College of Obstetricians and Gynecologists says that it may be appropriate for carefully selected patients. However, this technique is typically used in a hospital setting.

A Word From Verywell

It can be upsetting to hear that labor needs to be induced (and it can be hard to be overdue). This low-risk method may be helpful to jump-start dilation and contractions for many pregnant people. Overall, the use of the Foley balloon catheter is a safe and effective method of induction for most people. If you have any questions or concerns, discuss them with your obstetrician.